Abstract
BackgroundYunnan has the greatest share of reported human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) cases in China. In recent years, HIV prevalence and incidence remained stubbornly high in men who have sex with men (MSM). To follow the dynamics of the HIV-1 epidemic among MSM, HIV-1 genetic characteristics and genetic transmission networks were investigated.MethodsBlood samples from 190 newly diagnosed HIV-1 cases among MSM were continuously collected at fixed sites from January 2013 to December 2015 in Kunming City, Yunnan Province. Partial gag, pol and env genes were sequenced and used for phylogenetic and genotypic drug resistance analyses. The genetic characteristics of the predominant HIV-1 strains were analyzed by the Bayesian Markov Chain Monte Carlo (MCMC) method. The genetic transmission networks were identified with a genetic distance of 0.03 substitutions/site and 90% bootstrap support.ResultsAmong the 190 HIV-1 positive MSM reported during 2013–2105, various genotypes were identified, including CRF01_AE (45.3%), CRF07_BC (35.8%), unique recombinant forms (URFs) (11.6%), CRF08_BC (3.2%), CRF55_01B (2.1%), subtype B (1.6%) and CRF59_01B (0.5%). The effective population sizes (EPS) for CRF01_AE and CRF07_BC increased exponentially from approximately 2001–2010 and 2005–2009, respectively. Genetic transmission networks were constructed with 308 pol sequences from MSM diagnosed during 2010–2015. Of the 308 MSM, 109 (35.4%) were identified in 38 distinct clusters. Having multiple male partners was associated with a high probability of identification in the genetic transmission networks. Of the 38 clusters, 27 (71.1%) contained individuals diagnosed in different years. Of the 109 individuals in the networks, 26 (23.9%) had ≥2 potential transmission partners (≥2 links). The proportion of MSM with ≥2 links was higher among those diagnosed from 2010–2012. The constituent ratios of their potential transmission partners by areas showed no significant difference among MSM from Kunming, other cities in Yunnan and other provinces. Additionally, surveillance drug resistance mutations (SDRMs) were identified in 5% of individuals.ConclusionThis study revealed the various HIV-a genotypes circulating among MSM in Kunming. MSM with more partners were more easily detected in transmission networks, and early-diagnosed MSM remained active in transmission networks. These findings suggested that the routine interventions should be combined with HIV testing and linkage to care and early antiretroviral therapy among HIV-positive MSM.
Highlights
Despite substantial efforts to control human immunodeficiency virus-1 (HIV-1) in men who have sex with men (MSM), the HIV epidemic in MSM remains disproportionately severe in countries of low, middle and high income [1, 2]
This study revealed the various HIV-a genotypes circulating among MSM in Kunming
MSM with more partners were more detected in transmission networks, and early-diagnosed MSM remained active in transmission networks
Summary
Despite substantial efforts to control human immunodeficiency virus-1 (HIV-1) in men who have sex with men (MSM), the HIV epidemic in MSM remains disproportionately severe in countries of low, middle and high income [1, 2]. The annual rate of newly reported HIV cases attributed to MSM in China has increased from 2.5% in 2006 to 28.3% in 2015 [3, 4]. A meta-analysis found that the national HIV incidence among Chinese MSM was 5.0 per 100 person-years (95% CI: 4.1%-5.8%) [6], which was much higher than that of any other population in China. HIV prevalence and incidence remained stubbornly high in men who have sex with men (MSM). To follow the dynamics of the HIV-1 epidemic among MSM, HIV-1 genetic characteristics and genetic transmission networks were investigated
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